Fasting advisable for individuals with diabetes?
Fasting during Ramadan is a key pillar of Islam, and Muslims, including those with diabetes, may choose to participate. However, it's essential for individuals with diabetes to consult their healthcare expert before fasting to manage blood sugar levels and understand potential health risks. Factors such as the type of diabetes, treatment, and other health issues can influence these risks.
A risk-based classification identifies three groups of individuals:
Group 1 (Very High Risk): Includes those with:
- Poorly managed type 1 diabetes
- Low blood sugar levels or diabetic ketoacidosis in the three months before Ramadan
- Severe hyperosmolar coma episodes
- Frequent low blood sugar incidents
- Impaired low blood sugar symptom recognition
- Acute medical conditions
- Gestational diabetes or pregnancy complications requiring insulin or sulfonylureas
- Advanced cardiovascular disease
- Stage 4 or 5 chronic kidney disease or on dialysis
- Advanced age with poor health.
Group 2 (High Risk): Comprises individuals with:
- Poorly controlled type 2 diabetes
- Well-managed insulin-dependent type 2 diabetes
- Well-controlled type 1 diabetes
- Gestational diabetes or pregnancy with type 2 diabetes managed with basic therapy or metformin
- Stage 3 chronic kidney disease
- Cardiovascular disease
- Other chronic health issues
- Diabetics in physically demanding jobs.
Group 3 (Moderate to Low Risk): Consists of those with well-controlled type 2 diabetes managed through:
- Nutrition and exercise
- Oral antidiabetic medications (e.g., metformin, alpha-glucosidase inhibitors, glitazones, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors, basal insulin).
Individuals at very high or high risk (groups 1 and 2) are advised against fasting. If they choose to fast, they must receive guidance from their healthcare expert, ensure regular blood glucose monitoring, and adjust their medical treatment as necessary.
2. Checking sugar levels.
Blood glucose levels should be accurately assessed at least twice daily during Ramadan, with insulin users measuring levels three to four times a day. This is crucial due to the altered eating schedule, especially after substantial evening meals, to prevent hyperglycemia.
3. Effective diet plan.
Dietary and hydration changes during Ramadan can greatly affect blood glucose levels. A meal plan focusing on nutritious foods, like more vegetables and salads while limiting fried and sugary items, can help maintain stable blood sugar after meals.
After Ramadan, it's crucial to be mindful of food choices to prevent high blood sugar levels. Consulting a healthcare provider post-fasting is recommended to review diabetes management and adjust treatments as needed.
4. Exercise
It is recommended to avoid intense physical activities while fasting, as this could increase the likelihood of low blood sugar and dehydration. However, it is still important to include light to moderate exercise, like daily walks, during this time.
5. Medication and Use of Supplements.
During Ramadan, hypoglycemia may increase during the day and hyperglycemia at night. It's crucial to consult your physician about diabetes management before fasting to adjust medication dosage, timing, or type. Changes in eating and drinking patterns can also affect blood pressure and lipid levels, which should be addressed in your treatment plan. Adding supplements to your routine can also effectively help manage vitamins and mineral levels in diabetic patients during Ramadan.
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